Flett Jayde A M, Fletcher Benjamin D, Riordan Benjamin C, Patterson Tess, Hayne Harlene, Conner Tamlin S
Department of Psychology, University of Otago, P.O. Box 56, Dunedin 9054, New Zealand.
Department of Psychological Medicine, School of Medicine, University of Otago, P.O. Box 56, Dunedin 9054, New Zealand.
Internet Interv. 2019 Aug 23;18:100267. doi: 10.1016/j.invent.2019.100267. eCollection 2019 Dec.
Adherence is an important predictor of intervention outcomes, but not all measures of adherence are created equally. Here, we analyzed whether there was a discrepancy between self-report adherence and objective adherence in a digital mindfulness meditation randomised, controlled trial. A sample of 174 young adult undergraduate university students trialled either an app-based or email-based mindfulness meditation program (or an app-based attention control). Participants' adherence (number of sessions completed) and mental health was self-reported. Objective adherence data were provided by the owners of the digital mindfulness programs. We found evidence of inflated self-reported adherence to the app-based intervention and argue that the inflation was not explained by social desirability biases because participants were aware we would have access to object data and no remuneration was tied to adherence. We also comment on the different conclusions we would have drawn about the effectiveness of the digital interventions on mental health, had we used the self-reported adherence data rather than the objective adherence data. We use this example to suggest that it may be perilous to rely on self-reported measures of adherence when assessing the effectiveness of digital interventions.
依从性是干预效果的重要预测指标，但并非所有的依从性测量方法都是一样的。在此，我们分析了在一项数字化正念冥想随机对照试验中，自我报告的依从性与客观依从性之间是否存在差异。174名年轻的本科大学生参与了一项试验，他们被随机分配到基于应用程序或基于电子邮件的正念冥想项目（或基于应用程序的注意力控制项目）。参与者的依从性（完成的课程数量）和心理健康状况通过自我报告获得。客观依从性数据由数字化正念项目的所有者提供。我们发现了自我报告的基于应用程序干预的依从性存在夸大的证据，并认为这种夸大不能用社会期望偏差来解释，因为参与者知道我们可以获取客观数据，且依从性与报酬无关。我们还评论了，如果我们使用自我报告的依从性数据而非客观依从性数据，我们会对数字化干预对心理健康的有效性得出不同的结论。我们用这个例子表明，在评估数字化干预的有效性时，依赖自我报告的依从性测量方法可能是危险的。
